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Sometimes the best medicine is understanding.
There is a common saying that if the care we provide our clients is not culturally sensitive, then it is not trauma-informed.
I am a big believer in meeting our clients’ cultural needs, and in respecting and celebrating the beauty of their traditions. However, we need more than superficially pleasant interactions with individuals from diverse backgrounds, individuals who we label as “different than us” because of the way they look, talk, or practice their culture or religion.
Trauma sensitivity alone, I believe, is not enough. We need culturally responsive and effective care. I will give an example here, then expand on how to put this concept into action.
I recently walked into the inpatient unit where I work to find that my staff had called security and were about to inject or seclude a large, agitated black man. I asked if I could try to talk to him. As I listened, he asked that he only work with staff of color, asked for a menu fit for a Muslim man who only consumes halal/kosher meat, and asked if he could talk to an imam to learn how to pray again. We ended up not needing restraints or antipsychotics after all; all he needed that morning was human connection. I happen to share aspects of his cultural background, and that made him feel safe enough to open up to me.
It is not going to be possible to have non-white staff assigned to him all the time, but on this particular day that plan worked best.
There are 4 things to remember when bearing witness to individuals in distress:
1. Authenticity. Our clients will quickly discover if we genuinely care.
2. Curiosity. Show interest in them as humans, not only the labels assigned to them.
3. Flexibility. We must be ready to adjust our way of thinking, and in doing so, we can better meet their needs.
4. Humility. Maintain the attitude of a student, keen to learn from each encounter.
Psychiatry is not only a field of suffering or an industry of pain; there is also a lot of joy that we should get out of caregiving. If you are not looking for beauty in every interpersonal encounter you have with those you serve, then you have not yet touched the soul of medicine. By listening to and meeting patients’ cultural needs, we all win.
Dr Reda is a practicing psychiatrist in Providence Healthcare System, Portland, OR.